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Nearly 40 percent of adults in the U.S. 60 or older take at least five prescription drugs, and there's a good chance that at least one of them is unnecessary. Maybe they're drugs like sleeping pills that many people take long-term even though they generally shouldn't. Perhaps they're drugs that are no longer needed because lifestyle changes have helped resolve the problem. Or maybe they were improperly prescribed in the first place.
Whatever the reason, unnecessary medication poses needless risks and expense. But knowing when it's safe to stop isn't always easy. And even when stopping is OK, knowing how can be complicated, since it often requires tapering off over weeks to prevent withdrawal reactions. Here are some tips:
Don't stop on your own. Call your doctor before stopping unless you're having a severe allergic reaction or other life-threatening side effect.
Do a drug check. Bring all of your drugs to your doctor at least once a year to ask whether any can be eliminated.
Make a plan. For drugs that can be discontinued, work out a withdrawal schedule that includes follow-up visits.
Know the warning signs. Get a list of the symptoms that can be triggered by stopping the drug you're taking, and call your doctor if you notice any.
| Drug* | Risks of long-term use** | Risk of stopping abruptly** |
|---|---|---|
| Antidepressants, such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) | Dependence, sexual dysfunction, and weight changes |
Agitation, anxiety, confusion, insomnia, nightmares, nausea, and worsened, severe depression |
| Benzodiazepines, such as alprazolam (Xanax), lorazepam (Ativan), and triazolam (Halcion), used for anxiety, insomnia, and panic attacks | Dependence, dizziness, impaired coordination, memory loss, sexual dysfunction, and weight changes |
Agitation, anxiety, fast heartbeat, hallucinations, insomnia, seizures, sweating, tremors, and nausea |
| Cholesterol-lowering statins, such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor) | Cataracts, kidney or liver dysfunction, and muscle damage |
Rebound high cholesterol levels and heart attack |
| Corticosteroids, such as beclomethasone (Beconase AQ, QVAR), fluticasone (Flonase, Flovent), and hydrocortisone, for asthma, arthritis, rhinitis, and certain skin problems | Bone loss, cataracts, glaucoma, elevated glucose levels, infection, menstrual irregularities, and impaired ability of the adrenal gland to produce cortisol |
Fatigue, low blood pressure, muscle aches and pain, nausea, and weight loss |
| Heartburn drugs, such as esomeprazole (Nexium) and omeprazole (Prilosec) | Fractures, gastrointestinal infections, and pneumonia |
Rebound heartburn |
| Hormone therapy, such as estrogen (Premarin) and estrogen with progestin (Prefest, Prempro) | Blood clots, heart attacks, strokes, and breast and endometrial cancers |
Menopausal symptoms, such as hot flashes, flushes, and sweating |
| Nonsteroidal anti-inflammatories (NSAIDs),such as celecoxib (Celebrex) and ibuprofen (Advil), and aspirin | Gastrointestinal bleeding. With NSAIDs, heart attacks and strokes |
Heart attack (when you abruptly stop aspirin) and headaches (when you stop NSAIDs). |
| Opioids, such as hydrocodone, oxycodone, and propoxyphene | Constipation, dependence, drowsiness, mood swings, and nausea |
Agitation, chills, cramps, diarrhea, hostility, insomnia, muscle pain, and vomiting |
| Sleep aids, such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien) | Dependence, memory loss, dizziness, nightmares, sleep driving, and worsened sleep |
Anxiety, muscle cramps, nausea, and seizures |
* Many of the listed drugs are also available as generics.
** Not all of the risks apply to all of the listed drugs.
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